Provider Demographics
NPI:1194016071
Name:GARCIA, JANALYNN PATRICE NELSON (OT)
Entity Type:Individual
Prefix:MRS
First Name:JANALYNN
Middle Name:PATRICE NELSON
Last Name:GARCIA
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MISS
Other - First Name:JANALYNN
Other - Middle Name:PATRICE
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MOT
Mailing Address - Street 1:1519 132ND ST SE
Mailing Address - Street 2:SUITE A
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-7203
Mailing Address - Country:US
Mailing Address - Phone:425-357-9380
Mailing Address - Fax:425-357-9382
Practice Address - Street 1:2800 NORTHUP WAY
Practice Address - Street 2:SUITE 260
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-1440
Practice Address - Country:US
Practice Address - Phone:425-827-5877
Practice Address - Fax:425-827-5843
Is Sole Proprietor?:No
Enumeration Date:2011-04-26
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WATL 60216958225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0281113OtherL & I
WA0281099OtherL & I
WA0281071OtherL & I
WAG8902000Medicare PIN
WA0281099OtherL & I
WAG8904935Medicare PIN
WAG8902807Medicare PIN